• Ambulance service

Hardcore Medical & Ambulance Service

Overall: Good read more about inspection ratings

Unit A11, The Springboard Centre, Mantle Lane, Coalville, Leicestershire, LE67 3DW

Provided and run by:
Hardcore Medical & Ambulance Services Limited

All Inspections

During an assessment of Emergency and urgent care

This service is well-led
We rated this key question as good because the service used effective systems and processes to store medicines, and managed cleanliness and infection prevention well. Vehicles and equipment were well-maintained, the service demonstrated they had effective arrangements and processes in place to monitor the safety and upkeep of consumables, equipment and vehicles. The service managed patient safety incidents well. Leaders demonstrated the skills and abilities to run the service.

Leaders operated effective processes for governance, information management and the management of risk, issues and performance. Policies were relevant, appropriate and up to date and did reflect up-to-date national guidance. Leaders adhered to quality recruitment processes and ensured all staff were trained and competent for their role.

We saw evidence that the staff and leaders have a proactive learning culture, and they were able to provide evidence from internal newsletters and team meetings where they were able to demonstrate HMAS values which included patient-centric focus, open communication, ethical conduct, teamwork, continuous improvement and positive attitude throughout the organisation.

Staff and leaders told us HMAS had a proactive learning culture, underpinned by the providers own professional and reputational values.

The staff and leaders were able to demonstrate, explain and evidence HMAS values which included patient-centric focus, open communication, ethical conduct, teamwork, continuous improvement and positive attitude throughout the organisation.

Staff and leaders told us concerns are reported, and safety events are investigated, reported and lessons are learned. We found that the service leaders share investigation outcomes, lessons learnt, and improvement plans.

The service had established processes in place to learn from feedback, compliments and complaints. The service had a process in place to share feedback and communications with staff. We saw significant evidence of responsive actions and processes from both staff and leaders’ perspectives following feedback on the service. We found evidence of ongoing service wide learning and improvements to maintain good practice and meet HMAS own service values following feedback from staff, leaders, patients experience and NHS feedback.'

We rated this key question as good because leaders demonstrated the skills and abilities to run the service, and operated mostly effective processes for governance, information management and the management of risk, issues and performance.

Policies were relevant, up to date and reflected up-to-date national guidance. We identified some gaps in governance which we raised at the time of the inspection. Leaders took action to rectify this. Clinical staff (emergency care technicians) were not able to prescribe medicines independent therefore gave medicines to patients under patient group direction (PGD).

The service managed patient safety incidents well. Leaders demonstrated the skills and abilities to run the service. Leaders operated effective processes for governance, information management and the management of risk, issues and performance. Policies were relevant, appropriate and up to date and did reflect up-to-date national guidance. Leaders adhered to quality recruitment processes and ensured all staff were trained and competent for their role. Evidence reviewed showed us staff completed self-reflection and learning as part of their ongoing continuous professional development. We saw evidence that the NHS provider had provided compliments to Hardcore staff for their hard work, professionalism and dedication to patient care.

During an assessment of the hospital overall

Hardcore Medical Ambulance Service (HMAS) is a private ambulance service based in Leicester and Cheshire registered for emergency and urgent care. Services had a ad-hoc contract with the Northwest Ambulance service (NWAS). HMAS was formed in 2010 and provides services using emergency care and utilises ambulances designed for emergencies, patient transport and medical event journeys. The service is registered to provide the regulated activities: Transport services, triage and medical advice provided remotely and treatment of disease, disorder or injury.



The service managed patient safety incidents well. Leaders demonstrated the skills and abilities to run the service. Leaders operated effective processes for governance, information management and the management of risk, issues and performance. Policies were relevant, appropriate and up to date and did reflect up-to-date national guidance. Leaders adhered to quality recruitment processes and ensured all staff were trained and competent for their role. We assessed HMAS against a range of quality statements in the key questions, safe and well-led.

21 August 2018

During a routine inspection

Hardcore Medical & Ambulance Service is operated by Hardcore Medical & Ambulance Services Limited. The service provides an emergency and urgent care transport service.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced inspection on 21 August 2018.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led?

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Hardcore Medical & Ambulance Service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The service provides emergency and urgent care. It also provides first aid services at public events, which is not inspected by Care Quality Commission (CQC) because this falls outside of the scope of CQC registration.

Hardcore Medical & Ambulance Service registered with the Care Quality Commission in March 2017 and has not previously been inspected.

We rated this service as good overall. Our ratings were good for safe, effective, caring, responsive and well led.

We found the following areas of good practice:

  • The service had a positive safety culture. Incidents were reported appropriately and lessons learned shared throughout the team.
  • Staff received effective training in safety systems, processes and practices. Mandatory training compliance was at 95% and staff had good access to additional training relevant to their role.
  • Infection prevention and control (IPC) was given sufficient priority. Audit results demonstrated areas were clean and staff adhered to IPC practices.
  • Staff used recognised tools when monitoring patients for signs of deteriorating health and assessed patients against Joint Royal Colleges Ambulance Liaison Committee (JRCALC) protocols.
  • Nurses, a pharmacist and doctors were available as part of the service to act as clinical experts and were a source of support and information for all staff.
  • Individual care records were written and managed in a way that kept patient’s safe. Records were clear and complete, dated, timed and signed and followed Joint Royal Colleges Ambulance Liaison Committee (JRCALC) guidelines.
  • The service had patient group directions (PGDs) in place to enable qualified nurses to administer medications in a timely manner.
  • Policies, procedures and clinical guidelines were based on evidence-based best practice, national guidance and relevant legislation.
  • Ambulance response times were consistently better than times stated in the Ambulance Response Programme (ARP) approved by the Secretary of State for Health in 2017.
  • Without exception, online patient feedback was positive about the way they were treated by staff. Staff were described as "caring and non-judgemental". A relative, we spoke with, described the care as, "exceptional".
  • The service had received no complaints, either formal or informal, since registration in March 2017.
  • The operations and clinical director(s) had the skills, knowledge, experience and integrity that they needed to run the service.
  • The culture of the service encouraged candour, openness and honesty, staff told us they felt supported, respected and valued and directors described their staff as their "greatest asset".
  • The operations director had recently designed and introduced an online management application (App). The App, which was in the operational testing stage, provided the directors with an ‘all in one’ performance monitoring system that was accessible by any member of the team.

However, we also found:

  • The service did not monitor the room temperature where medicines were stored.

Following this inspection, we told the provider that it should ensure action is taken to comply with the regulations. Details are at the end of the report.

Heidi Smoult

Deputy Chief Inspector of Hospitals on behalf of the Chief Inspector of Hospitals